Situs solitus

Last revised by Dr Daniel J Bell on 02 Nov 2020

Situs solitus (rare plural: sitūs soliti) refers to the normal position of the thoracic and abdominal organs. This will include a left-sided heart, also known as levocardia.

Radiographic features

Plain radiograph

On plain radiograph, careful attention should be directed at the location of the aortic arch, gastric fundus, cardiac apex, pulmonary fissures and the branching pattern of the bronchi, in order to ensure that the situs is solitus.

The aortic arch, gastric fundus, cardiac apex and splenic shadow should all be left-sided (a left-positioned heart is known as levocardia). The bronchi branching pattern should not be symmetrical; the right main bronchus should be shorter and more vertically oriented than the left main bronchus. The minor fissure should be only visible on the right side. The liver shadow should be right-sided.

Ultrasound, CT and MRI

The above findings also apply to these modalities, albeit seen with more precision than on plain radiograph.

See also

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Cases and figures

  • Normal frontal chest x-ray
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